Active NPI
Jordan Matthew Suarez, PT
- Physical Therapist
- Lawrenceville, GA
National Provider Identifier
1942991328
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016535
- Practice address
- 1860 Atkinson Rd Ste 101
Lawrenceville, GA 30043-5066 - Phone
- (678) 442-7861
- NPI assigned
- May 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016535 | GA | Primary |
Addresses
Primary practice location
1860 Atkinson Rd Ste 101
Lawrenceville, GA 30043-5066
Mailing address
833 Monroe Dr NE Apt 1
Atlanta, GA 30308-4514
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230705000104 | GA | Practitioner - Physical Therapist in Private Practice | 6608235957 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016535 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1684281600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1684281600000",
"number": "1942991328",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "833 MONROE DR NE APT 1",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303084514"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1860 ATKINSON RD STE 101",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300435066",
"telephone_number": "678-442-7861"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUAREZ",
"first_name": "JORDAN",
"middle_name": "MATTHEW",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-05-17",
"last_updated": "2023-05-17",
"certification_date": "2023-05-17",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT016535",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.